Evidence map›Paper›PMID 41068413›Full record

Trial reportSurgical endoscopy2026

Learning curve estimation and insertion depth in Veress needle insertion using a conventional Veress needle and the VeressPlus™ needle.

Tim Horeman-Franse, Roelf Postema, David Cefai, Sem Frederik Hardon, Predrag Andrejevic, Jenny Dankelman, Jean Calleja-Agius, Christian Camenzuli

Abstract readRandomized Controlled TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Tim Horeman-FranseDepartment of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands. t.horeman@tudelft.nl.ORCID 0000-0002-8527-4486
Roelf PostemaDepartment of Surgery, University Medical Centers Amsterdam, Location VUMC, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
David CefaiEngineering Department, 2631CM, ProVinci Medtech, Nootdorp, The Netherlands.
Sem Frederik HardonDepartment of Surgery, University Medical Centers Amsterdam, Location VUMC, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Predrag AndrejevicDepartment of Surgery, Mater Dei Hospita, University of Malta, Msida, MSD2080, Malta.
Jenny DankelmanDepartment of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands.
Jean Calleja-Agius *Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, MSD2080, Malta.
Christian Camenzuli *Department of Surgery, Mater Dei Hospita, University of Malta, Msida, MSD2080, Malta.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Veress Needle (VN) is commonly used in establishing pneumoperitoneum in laparoscopic surgery. However, severe vascular and/or visceral complications can occur due to overshoot at the insertion of the VN in the abdominal cavity. In order to investigate whether the new VeressPLUS needle (VN+) could improve safety, the learning curve of this needle was compared to that of a conventional VN, under standardized conditions.

methodsIn total, 26 residents and med students, without prior Veress needle experience, were recruited and randomly assigned to VN or the VN+ group. A learning curve plateau phase recognition model was developed and used to determine the learning curve of the participants who used either the VN or the VN+ needle on two Thiel-embalmed human cadavers. Insertion of the needles was done in a systematic way in the upper abdomen and insertion depth was measured under direct laparoscopic vision. At the end of the learning curve, the number of participants that reached a safe insertion depth between 5 and 15 mm was compared.

resultsOn average, it took the VN group 8 trials to reach and establish the plateau phase of the learning curve. The VN+ group showed no learning curve at all. At the 8th trial, a significant difference (p < 0.002) in average insertion depth was found in favor of the VN+ (mean: 5.4 mm SD 1.4) compared to the VN (mean: 12.7 mm SD 6). In the VN group and VN+ group, 46% versus 8% exceeded the safe insertion depth of 10 mm at the end of the learning curve.

conclusionThis study indicates that for novices, there is no learning curve for the VN+, when compared to VN. Moreover, in all cases, the insertion depths were significantly reduced (with more than 50%) while using the VN+ when compared to the VN.

Indexed as

LaparoscopyLearning CurveNeedlesPneumoperitoneum, ArtificialAdultCadaverClinical CompetenceEquipment DesignFemaleHumansInternship and ResidencyMaleEntry techniqueLaparoscopySafety mechanismVeress needle

Identifiers

PMID41068413
PMCPMC12823718

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.